Provider Demographics
NPI:1992568802
Name:SEED SOWING SISTAH MOVEMENT, LLC
Entity type:Organization
Organization Name:SEED SOWING SISTAH MOVEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/
Authorized Official - Prefix:
Authorized Official - First Name:PATRICE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANTLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:216-356-1031
Mailing Address - Street 1:11868 CLIFTON BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-2025
Mailing Address - Country:US
Mailing Address - Phone:216-356-1031
Mailing Address - Fax:
Practice Address - Street 1:4302 GUNN HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-8785
Practice Address - Country:US
Practice Address - Phone:305-450-7566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-02
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty